Glaucoma

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Macular Degeneration

Written by Brenton Wight, Health Researcher, LeanMachine
Copyright © 1999-2020 Brenton Wight. All Rights Reserved.
This site is non-profit, existing only to help people improve health and immunity
Updated 9th November 2020

What is Macular?

AMD (Age-related Macular Degeneration) is a type of central vision loss.
Central vision is essential for driving, reading, facial recognition, etc. The macula is an area covering only 2.1% of the retina, and 5.5mm diameter, but the most important.
AMD is the leading cause of vision impairment in the over-40s in Australia.

 

If we look at the black dot in the grid above, one eye at a time, we should see perfectly straight lines and the black dot in the centre.

If we view the same grid but see any distortion in the chart, as this sample of advanced AMD vision, or if there is smudging or invisible areas, see an optometrist or ophthalmologist as soon as possible.

Types of AMD


1. Dry AMD (nonexudative AMD or atrophic AMD) is the most common.
2. Wet AMD (Neovascular AMD) affects only around 20% of sufferers, but is more serious.
Note: Often confused with Epiretinal membrane, often called a macular pucker, which can cause similar symptoms, but is quite different. This is a thin, almost transparent layer of fibrous cellular material, released from the retina and other parts of the eye into the vitreous gel that then settles to form a film over the macula, affecting vision. Epiretinal membranes can resolve on their own, and mild conditions may not need further attention. In some cases, Vitrectomy surgery may be required, involving removal and replacement of some or all of the vitreous humor (fluid or gel) from the eye, and lifting the film from the macula. Has a fairly good success rate.

Age-related is a misnomer

Doctors say the cause of AMD is unknown, but as it happens more in seniors, it is age-related, or genetic.
But the evidence now points to diet rather than age.
Dr. Chris Knobbe, Ophthalmologist and founder and president of the Cure AMD Foundation, believes that the skyrocketing rates of AMD worldwide are actually caused by the increased consumption of processed food, and has nothing to do with age or genetics.
Before 1925, there were about 50 reports of macular degeneration world-wide, even though Ophthalmologists had instuments to view the macula from the 1860’s.
Macular degeneration became only slightly more common in the 1940’s.
In 1975, over 4 million Americans had macular degeneration.
In 2019 there are over 180 million people with Macular Degeneration, and it is predicted that by 2040 this number will grow to over 280 million.
Research is now clearly pointing to processed foods as the culprit, mainly margarine, canola oil and other factory-produced franken-foods, already proven to cause cancer, cardiovascular disease, blood pressure, obesity, diabetes, stroke, and now AMD as well.

Preventing AMD

As there is no “cure” for AMD, prevention is our best option. Dietary changes can help prevent AMD, and at the same time, prevent cardiovascular, cancer, stroke, blood pressure, diabetes, obesity, Alzheimer’s and more.
Apart from the diet, we need to get more quality sleep, by eliminating blue light (computer screens) and sleeping in total darkness.

AMD Symptoms

AMD has no symptoms in the early stages.
Later symptoms include:

  • Distortion, but sometimes blur or missing image in central vision
  • Reduced definition of colours, or dim colour vision
  • Central vision blocked by dark shapes
  • Difficulty with close work, e.g. reading
  • Central vision loss

Macular degeneration does not cause any pain.
See an optometrist or ophthalmologist as soon as possible if you notice any symptoms, or have any distortion on the chart.
Depending on the type of AMD, there are treatments, diet and lifestyle changes that can slow or stop vision loss, and may even improve vision.

High risk groups:

  • Those over 60
  • Family history of AMD
  • Smoking = 3 x risk
  • Obesity
  • Those working with computer, phone or TV screens
  • Caucasians have a higher risk than other races
  • Those with high blood pressure
  • Diet containing trans fats
  • Cardiovascular disease
  • Females have higher risk

Smoking damages the retina, and increases risk of AMD an average of 3 fold. The retina requires a lot of oxygen, which is depleted in smokers.

Cause of AMD

Doctors still cannot pin-point a cause, but there are many things to help prevent or treat the condition.

Official AMD Treatment

Dry AMD Official medical treatments available for dry AMD appear to be very limited.
For now, positive changes to diet and lifestyle slows disease progression.
Note: Dry AMD can progress to wet AMD, so any sudden changes in vision should be immediately reported.
More info at: www.mdfoundation.com.au/content/dry-macular-degeneration-1
Wet AMD
The protein VEGF (Vascular Endothelial Growth Factor) is mainly responsible for leaking and growth of new blood vessels that result in rapid and severe vision loss, which if left untreated, becomes permanent.
Anti-VEGF drugs can be injected into the eye to slow or stop the AMD process.
Monthly injections are used for three months, then continued on an indefinite basis at an interval determined by the ophthalmologist in consultation with the patient. Injection treatment advice:
Injection treatment is not long, and normally carried out in the ophthalmologist’s rooms, but sometime in a day surgery facility.
Anaesthetics are given pre-injection, to reduce discomfort. If there is no apparent change in vision, appointments should still be kept to ensure there really is no change.
The Amsler grid should be used daily for each eye, any sudden vision changes should be reported urgently. Treatment may still require continuation, even if vision has stabilised or improved.
Read more: www.mdfoundation.com.au/content/wet-macular-degeneration

Stem Cell Technology

Scientists in Sweden innovated a method of treating blindness using embryonic stem cells to produce retinal cells. The team at Karolinska Institutet and St Erik Eye Hospital reported in March 2020, their approach of using CRISPR/Cas9 gene editing to amend retinal cell production so the generated cells can hide from the body’s immune system, protecting them from becoming rejected. Read more:
www.news-medical.net/news/20200330/Developments-in-treating-blindness-using-retinal-cell-production.aspx

Drugs for AMD

Lucentis® (Lampalizumab) is a drug that binds to Complement Factor D, a protein which is encoded by the CFD gene in humans.
It is a treatment for dry AMD, but appears to work best in patients with complement-risk genes. Genetic testing may be appropriate if this treatment is considered.

Eylea® (Aflibercept) is an anti-VEGF drug developed for wet AMD.
Avastin® (Bevacizumab) is an anti-VEGF drug, originally developed as a cancer drug. Not registered by the TRGA (Therapeutic Goods Administration) for use in the eye, so this use is “off-label”. Typically used for Australians not eligible for the approved drugs Lucentis or Eylea via POBS (Pharmaceutical Benefits Scheme).

Laser Treatments

PDT (Photodynamic Therapy) combines Visudyne, a light-activated drug, with cool laser light, directed on the relevant retinal area to seal and halt or slow progression of abnormal retinal blood vessels. The patient MUST avoid sunlight for 24 to 48 hours after drug infusion.
Patients having PDT usually continue to lose vision in the first six months of treatment, but then usually stabilises, halting severe vision loss, where anti-VEGF drugs start working faster.
PDT is now rarely used for normal AMD, but sometimes used with an anti-VEGF drug for patients with the polypoidal choroidal vasculopathy type of AMD, as this condition does not settle completely using anti-VEGF drugs alone.

Laser photocoagulation uses a concentrated beam of high-energy thermal light, directed to the retina to destroy and seal leaky blood vessels. The laser also destroys the retina adjacent to the blood vessel, so is used mainly to treat a small percentage of wet AMD patients who have new vessels not in the central vision.
Laser photocoagulation has a 50% recurrence rate, so close follow up and monitoring is essential.

Natural treatment for AMD

Food is vital, but only natural food, nothing processed. Processed foods are anything found in a supermarket on a box, bag, can etc.
Natural foods are only found in the greengrocery section, preferably in the organic area.
We should all aim for all foods in this area, with at least one meal daily as raw food, because we must have enzymes for optimum health and immunity.
Enzymes in raw food are destroyed by heating to over 50 degrees C (122 degrees F) which is about the temperature of hot water at the kitchen sink in most homes.
When cooking food, steaming is best. If we heat food over 120 degrees C (148 defrees F) by baking in the oven or frying etc, then AGEs (Advanced Glycation End-products) are formed from proteins or fats, which, just like the AGE acronym, cause premature ageing, and a much higher risk for AMD as well as glaucoma, cataracts and other eye disease, as well as blood pressure, strokes, heart attacks, brain disease, diabetes and other “modern” disease that did not exist 100 years ago.
Best foods are green leafy vegetables, broccoli, brussels sprouts, cabbage, lettuce, capsicum, cucumber, lemons, bananas, apples, spinach and berries of all kinds.
Eggs are great, with Nature’s perfect packaging, but should be boiled for 10 minutes to destroy any pathogens, and not fried or any other high-temperature methods.
Limited full-fat dairy is fine unless there are allergies, but low-fat dairy should be avoided, as the nutrition is in the fat, not in the water.
Fish has Omega-3 fatty acids that benefit the eyes as well as the heart and brain. Again, steaming is the best way to cook fish.
Coconut Oil was used in an animal study to show significant reduction in caspase-3 activity (a protease enzyme causing inflammation and apoptosis).
Coconut oil helped protect the integrity of healthy cells in retinas through an anti-apoptotic mechanism, supporting a direct link between caspase-3 and progression of light-induced retinal degeneration.
Coconut oil is one of the healthiest oils we can consume, also boosting brain function in a single dose, increasing HDL (“good” cholesterol), reducing body-mass index (BMI) and waist circumference. Coconut oil reduces wound-healing time when applied topically.

Supplements for AMD prevention

The AREDS (Age-Related Eye Disease Study) found benefits of high dose supplements that helped prevent or treat AMD, and recommended that those diagnosed with AMD or at high risk should use these supplements as a guide.
The original AREDS study of zinc and antioxidants slowed progression of AMD by 20% to 25% for those in the intermediate or late stage of AMD, and delayed vision loss. The follow-up AREDS2 study included lutein/zeaxanthin.
The AREDS2 formula (daily dose):

  • Zinc (as zinc oxide) 80mg
  • Vitamin C 500mg
  • Vitamin E 400IU
  • Copper (as cupric oxide) 2mg
  • Lutein 10mg
  • Zeaxanthin 2mg

However, LeanMachine regards most of these ingredients as sub-standard or even harmful, even though they helped those in the study.
One example of a product NOT to buy:
Bausch & Lomb, PreserVision, AREDS 2 Formula claims to conform to AREDS2 formula, but LeanMachine does not endorse this product.
Their Vitamin E is a synthetic dl-alpha-tocopherol (natural versions have a “d” prefix, d-alpha-tocopherol, where a “dl” prefix means an artificial product), and does not contain tocotrienols or the beta, gamma and delta versions of each, which make up the 8 components of Vitamin E.
Also it contains titanium dioxide (brain and nerve damage and a Group 2B carcinogen)

Also contains food dyes red #40 and blue #1 (can be contaminated with cancer-causing agents).
Contains Cupric oxide, but negligible copper is absorbed from this form.
Zinc oxide is dangerous and can damage DNA.

While healthy foods will help delay AMD, as well as reducing risk of diabetes, cardiovascular disease, Alzheimers, obesity, other eye disease and more, there is often not enough healthy content available to give the AMD patient enough of the correct nutrition, due to intensive farming practices, combined with toxic chemical additives in the soil.
Lean Machine recommends a combination of a healthy diet, supplements and sun exposure for optimum nutrition.
Oxidative stress is a major factor in progression of AMD, so antioxidants are important.
Various vitamins and minerals have been proven to reduce AMD symptoms, but eye doctors seldom pass on this information.
Supplements do not make up for a bad diet. Supplements often only supply a single important extract, but whole, natural foods contain fibre, enzymes and many other important compounds, so LeanMachine recommends a combination of both.
The following are the main supplements LeanMachine recommends for AMD patients:

  • OptiZinc is much better absorbed and much safer than zinc oxide. Also includes copper, but not enough, see chelated copper below
  • Vitamin C
    – Pure pharmaceutical grade ascorbic acid powder is economical and effective. 1/4 teaspoon daily is 1250mg, more than enough for AMD, and added benefit for preventing or slowing progression of cataracts
  • Vitamin E
    contains the extra 4 tocotrienols missing from cheap vitamins. Also good for the heart
  • Chelated Copper is much better absorbed, and much safer than Cupric Oxide. Note: Metallic copper is bad for the body. Copper cookware should not be used, and a Reverse Osmosis system should be used for all drinking and cooking to help eliminate fluoride, metallic copper, lead, arsenic, aluminium and other toxins
  • Lutein with Zeaxanthin. Lutein is extremely important as an antioxidant for eye health. This product includes OptiLut which increases lutein bio-availability, and also includes zeaxanthin

LeanMachine also recommends the following as added protection for AMD:

In addition, mitochondria health is essential. Foods improving mitochondria are:
1. Proteins such as fish, nuts, seeds, beans, lentils, eggs that support Glutathione and other amino acids which protect the mitochondria.
2. Antioxidants – colourful vegetables, fresh fruit, herbs, spices, berries. Best spices are cloves and turmeric.
Supplements for Glutathione include:

Inform the doctor of any other medical conditions and any other medications, vitamins or mineral supplements.

Other Eye Disease

Many other conditions affect sight, and I will discuss these later in separate articles. Of course, it is quite possible to have more than one condition, so early diagnosis is essential so we are more likely to be dealing with the first condition without confusing treatment with two or more conditions.
Here are a few of the most common:

  • Epiretinal membrane is often confused with Macular Degeneration, but is a film over the Macula
  • Diabetic Retinopathy affects blood vessels in the retina, and is the most common cause of vision loss among diabetics.
  • glaucoma affects peripheral vision.
  • Cataracts where the lens gradually becomes opaque
  • CMV Retinitis an infection of the retina, often affecting those with poor immunity or with AIDS
  • Diabetic Macular Oedema caused by fluid accumulation in the macula causing severe blurred vision
  • Retinal Detachment the retina separates from the nerve tissue and blood supply underneath it
  • Uveitis is inflammation of one or more of the uvea, the nerve tissue, and/or blood supply underneath. Common with Sarcoidosis

Eye Checkups

Everyone should get an annual eye check.
Most people are first checked by an optometrist, and when a problem is found they are normally referred to an ophthalmologist.
First, after a quick eye chart test, with and without glasses, amblyopia (“lazy eye”) is tested by covering one eye and looking for movement in the other eye, also ocular motility testing to determine how well the eyes follow a moving object, and stereopsis or depth perception.
Then a refraction test checks the degree of hyperopia (farsightedness), myopia (nearsightedness), astigmatism and presbyopia to determine a prescription of any eye-glasses required.
Eye drops are used to enlarge the pupils and allow better scrutiny of the inner eye.
Warning:These drops can last 4 to 6 hours, and when the patient ventures out into bright light, the pupils cannot respond quickly by reducing the pupil size, so glare and blurred vision can make driving or other activities dangerous, but everyone has a different reaction, and sun glasses are a must.
The doctor uses a “slit lamp” and checks the eyelids, cornea, conjunctiva, iris, and lens. Conditions are checked for retinal detachment, dry eye, blocked tear ducts, drainage problems, cataracts, macular degeneration, corneal ulcers, diabetic retinopathy and other eye disease.
The retina is examined and usually retina photographs are taken for reference in future tests to check for any change.

Colour blindness is normally checked using the Ishihara Color Vision Test booklet, each page containing a circular pattern comprising many dots of various colors, brightness and sizes, making up a single digit number. The full test contains 38 fifferent pages, but a basic test will only involve 14 or 24 different pages. A colour-blind person will see no number, or a different number in this test. Any problems in colour blindness may indicate a health problem such as glaucoma, MS (multiple sclerosis), diabetic retinopathy, macular edema and other disorders, as well as color vision issues caused by long-term use of some prescription medications.
For colour-blind people, specially tinted glasses can improve the distinguishment and vividness of various colours as a vision aid.
The retina has cone photoreceptors, and the red and green cones are often most affected, causing “red-green colour blindness”.

Foods to avoid

  • Baked foods. Gluten from wheat products damages the gut, even if we are not diagnosed as a Celiac.
    All baked goods are not natural, contain very little nutritional value, and have been subjected to high temperatures causing AGEs
  • Processed meats, as almost all cold meats contain sulfite or nitrite preservatives (chemical numbers in the 200 series) which are known to cause cancer and Alzheiner’s
  • Soft drinks, as almost all contain 211 or other 200 series chemical preservatives that cause cancer, as well as sugar and/or artificial sweeteners that also cause cancer
  • Fruit juices, as many have added sugar and/or preservatives, etc. Better to eat a piece of fruit, as the fibre aids gut bacteria and digestion, and the chewing slows down consumption. Immunity starts in the mouth, with saliva starting the breakdown of food. This benefit disappears when gulping down juice
  • Anything fried and almost everything else at the take-away counter. If we need take-away food, try a fresh apple and keep the doctor and the ophthalmologist away
  • Low-fat anything. Fat-reduced foods have been processed, and usually fats have been replaced with sugar, one of the worst culprits for inflammation and disease of all types
  • Any foods with added or “fortified” iodine, folic acid, iron, vitamin D, etc as invariably these are cheap supplements and are quite often causing damage to the body by blocking uptake of the real nutrients in food
  • Bad fats – Margarine – do not be fooled by unscrupulous advertising from margarine manufacturers who claim that margarine reduces cholesterol. Maybe it does at first, but cholesterol is not our enemy, only OXIDISED Very Low LDL is bad, and that is the main ingredient in margarine. Alternative: Coconut oil, butter, cold olive oil.
  • Canola oil – heat processing in production oxidises this fat. Cooking with canola oil oxidises the fat even more. NEVER use canola oil for anything.
    Alternative: Coconut oil
  • Sunflower Oil – similar problem to canola oil. Flaxseed or coconut oil is a much healthier alternative.

Bad drugs

  • Paracetamol, panadol, acetaminophen, tylenol – different names for the same drug marketed as “safe and effective” but it destroys L-Glutathione, the body’s own master antioxidant, and damages the liver. Around 90% of patients on the liver transplant waiting list are there because of paracetamol overdose. Alternatives for pain:
    (a) MSM – primarily for joint pain but helps reduce the sensation of any pain.
    (b) Bacopa – primarily for slight blood thinning and higher brain function, but also helps with pain
  • Statins – cholesterol lowering drugs that increase risk of diabetes, clobber our Vitamin D, cause muscle pain, liver and kidney disease, reduced immunity, and on average may slightly reduce risk of a heart attack but increase death risk from all other causes, so most people taking statins will not live one day longer, and have a poor quality of life
  • Aspirin increases risk of Wet AMD by causing leakage of blood vessels under the macula, causing scar tissue.
    Do not take aspirin for cardiovascular disease or pain, as the risks for internal bleeding and/or Wet AMD outweigh any advantages. Read more in my Blood Thinner article

Cooking Methods

The best cooking method is NONE. Heating food over around 50 degrees Celcius (about the temperature of hot water at the kitchen sink) destroys most or all of the beneficial enzymes, so salads, fruit or other cold foods should be consumed at least once daily. An organic apple a day keeps the doctor and the ophthalmologist away…
The second best cooking method is STEAMING, which means a maximum of 100 degrees Centigrade (212 degrees F). Other cooking methods heat food well over the safety limit of 120 degrees Centigrade. Over 120 degrees C, AGEs (Advanced Glycation End-products) form, which change the chemical structure of the food, causing damage to the mitochondria and many body systems.
Microwaving also damages the chemical structure of food, and studies show negative blood test results in humans after consuming microwaved food.

Disclaimer

LeanMachine is not a doctor, and the needs of each individual varies, so everyone should consult with their own health professional before taking any product to ensure that there is no conflict with existing prescription medication.
LeanMachine has been researching nutrition and health since 2010, and has now examined thousands of studies, journals and reports related to health and nutrition and this research is ongoing.
Copyright © 1999-2020 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285. All rights reserved.

Glaucoma

Written by Brenton Wight, Health Researcher, LeanMachine
Copyright © 1999-2020 Brenton Wight. All Rights Reserved.
This site is non-profit, existing only to help people improve health and immunity
Updated 23rd November 2020

What is Glaucoma?

Over 60 million people in the world have glaucoma, but only 30 million know they have it as there are no warning signs.
High intra-ocular pressure causes destruction of retinal ganglion cells, leading to vision loss.
Cataracts are the leading cause of blindness and Glaucoma is second.
There is no cure for glaucoma. Treatments focus on reducing intra-ocular pressure, but this does not always prevent further degradation.
High risk groups:

  • Those over 60
  • Those with a family history
  • Diabetics
  • Those who are severely nearsighted
  • Those with light colored eyes. Grey or blue eyes have the highest risk, brown the least
  • Those with increased IOP (intra-ocular pressure)
  • Those with compromised blood flow to the optic nerve
  • Those living with air pollution

Glaucoma?

In wide angle glaucoma, the most common form, changes in the trabecular meshwork prevent the aqueous liquid from draining correctly, resulting in an increase in the pressure (inta-ocular pressure) inside the eye.
image trabecular meshwork
The trabecular meshwork is an area around the base of the cornea, responsible for draining the aqueous humor (the liquid in the eye).
The increase in pressure causes destruction of retinal ganglion cells that form part of the optic nerve, resulting in peripheral vision loss, i.e. less vision in the extreme left, right, high and low fields, while the central vision remains relatively intact until the progression of vision loss in the extremities slowly creeps toward the centre of vision.
As glaucoma is more common as we age, and AMD (Age-related Macular Degeneration) is also more common as we age, and affects the central vision, we must look after the health of our eyes to retain as much vision as possible.
In my upcoming article on Macular eye disease, I will discuss the fact that Age-related Macular Degeneration has NOTHING to do with age, but many other factors such as taking aspirin, which increases the effect of blood leakage in the macular area of the retina, compounding the degeneration.
We must look at both conditions, as if we lose central as well as extremities vision, hope for retaining any eyesight is poor.

Cause of Glacoma

Doctors cannot explain why some people get glaucoma and others do not, even if their intra-ocular pressure is raised.
Mitochrondrial dysfunction appears to be the main cause, according to recent studies on glaucoma-prone mice, where glaucoma progression was halted by high doses of Niacin (Vitamin B3), or in particular, by NAD+ which is a derivative of B3. NAD (Nicotinamide adenine dinucleotide) exists in the body in two forms, the oxidized form NAD+ and reduced form NADH. As we age, we produce less and less NAD, which explains increasing risk for glaucoma as well as many other age-related conditions. Seniors have only half the mitochondria of young people.
The mouse studies used a very high dose of Vitamin B3, equivalent to a human taking 40 grams. A typical high-dose Niacin is low in cost and good insurance, improving cardiovascular health as well.
Even better is NADH which is more expensive, but many times more effective.
Also, mitochondrial function can be improved with PQQ, (Pyrroloquinoline Quinine).
A recent study on air pollution:
“The more polluted the air, the higher the risk is that those who live in that area will develop glaucoma”, claims a new study from the UK, published in the journal Investigative Ophthalmology and Visual Science. Researchers found that when the amount of fine particulate matter (FPM, particles 2.5 microns or less in diameter, also called PM 2.5) was higher, the rate of self-reported glaucoma was increased by at least 6%, in contrast to the areas with the least air pollution.

If we ask our Optometrist if there is any food or supplement that can help ward off glaucoma, they will usually say “There is nothing you can do. Take your eye drops, and prepare for surgery.”
Yet, their own web site contains the study info: www.optometry.org.au/blog-news/2017/3/6/vitamin-could-stop-glaucoma/
Could it be that they do not want to lose patients? Why not advise everyone that a daily dose of Vitamin B3 has no side effects and may just stop us from going blind!

See studies below on NADH.

This is not surprising to LeanMachine. I have been advising people for years that most age and lifestyle diseases are caused by mitochondrial dysfunction. Cancer research has all been about genetics, but it is the mitochondria that produces a chemical that produces apoptosis, the programmed cell death of an unhealthy cell. Without healthy mitochondria, we are at a higher risk for cancer, as we need the mitochondria to destroy sick cells before the cancer gets a foothold.
Mitochondria are the energy-producing organelles inside the cytoplasm of every living cell, producing ATP (Adenosine Triphosphate) which we need for everything we do.
As babies, each cell in our body has over 2,000 mitochondria, inherited only from our mother. Some cells requiring more energy have more mitochondria, like heart muscle cells, having around 5,000 mitochondria. At senior age, we only have a few hundred. Exercise increases mitochondria, there is a good reason to get off the couch.

Types of Glaucoma

  • Open Angle (chronic) Glaucoma – the most common type where aqueous fluid drains too slowly from aging of the drainage channel, causing pressure to build inside the eye. Younger people can also get this type. People do not notice vision changes at first because the sharpness of central vision is retained until late stages
  • Normal Tension Glaucoma – also called Low Tension or Normal Pressure Glaucoma. Not related to high pressure, but where the optic nerve is damaged even at normal pressure, or reduced blood supply to the optic nerve. Symptoms include migraine headaches, cold hands and feet, low blood pressure or other blood vessel problems. Those of Japanese descent have a higher risk
  • Acute Angle Closure Glaucoma – where the eye drainage becomes blocked, resulting in a sudden rise in pressure requiring emergency medical care. Symptoms can include blurred vision, severe headaches, eye pain, nausea, vomiting, rainbow-like halos seen around bright lights. Sometimes there are no symptoms. Higher risk for those of Asian or Native American descent
  • Angle Recession Glaucoma – Caused by trauma (injury) to the eye, which allows debris in the eye to gradually block drainage channels, raising the pressure. If treated early, vision can be saved
  • Primary Congenital Glaucoma – 1 in 10,000 babies are born with this hereditary condition. Family history with both parents increases likelihood, but often there is no family history on either side. If the first and second child have it, later children have very high risk. Boys have double the risk as girls. Sometimes affects one eye, but most often affects both. Untreated, this is a major cause of blindness in children. When treated before age 3, eyesight is normally saved. Symptoms include:
    1. Baby closes eyelids as if trying to protect the eye
    2. Baby seems overly sensitive to light
    3. Baby tears up more than normal
    It is imperative to check these warning signs in all infants
  • Secondary Glaucoma – Result of another eye condition such as inflammation, trauma, tumour, uveitis

Other Eye Disease

Many other conditions affect sight, and I will discuss these later in separate articles. Of course, it is quite possible to have more than one condition, so early diagnosis is essential so we are more likely to be dealing with the first condition without confusing treatment with two or more conditions.
Here are a few of the most common:

  • Diabetic Retinopathy affects blood vessels in the retina, and is the most common cause of vision loss among diabetics.
  • Macular Degeneration affects blood vessels in the visual centre (Macula) of the eye. There are wet and dry types.
  • Cataracts where the lens gradually becomes opaque
  • CMV Retinitis an infection of the retina, often affecting thise with poor immunity or with AIDS
  • Diabetic Macular Oedema caused by fluid accumulation in the macula causing severe blurred vision
  • Retinal Detachment the retina separates from the nerve tissue and blood supply underneath it
  • Uveitis is inflammation of one or more of the uvea, the nerve tissue, and/or blood supply underneath. Common with Sarcoidosis

Diagnosis

Typical Eye ChartEveryone should get an annual eye check. In some people, an astute eye doctor can see by the shape of the eye if a person is at high risk, even before they have high pressure or symptoms.
Most people are first checked by an optometrist, and when a problem is found they are normally referred to an ophthalmologist.
The Standard Eye Test: First, after a quick eye chart test, with and without glasses, amblyopia (“lazy eye”) is tested by covering one eye and looking for movement in the other eye, also ocular motility testing to determine how well the eyes follow a moving object, and stereopsis or depth perception.
Then a refraction test checks the degree of hyperopia (farsightedness), myopia (nearsightedness), astigmatism and presbyopia to determine a prescription of any eye-glasses required.
Eye drops are then used to enlarge the pupils and allow better scrutiny of the inner eye.
Warning: These drops can last 4 to 6 hours, and when the patient ventures out into bright light, the pupils cannot respond immediately by reducing the pupil size, so glare and blurred vision can make driving or other activities dangerous, but everyone has a different reaction, and sun glasses are a must.
The doctor uses a “slit lamp” and checks the eyelids, cornea, conjunctiva, iris, and lens. Conditions are checked for retinal detachment, dry eye, blocked tear ducts, drainage problems, cataracts, macular degeneration, corneal ulcers, diabetic retinopathy and other eye disease.
The retina is examined and usually retina photographs are taken for reference in future tests to check for any change.

Typical Retina PhotographThe glaucoma tests:
Eye stain drops are used to check drainage.
Eye pressure is tested using either:
1. NCT (non-contact tonometry) or “puff-of-air” test which measures pressure.
2. Yellow numbing drops are usually used which glow when exposed to blue light. An applanation tonometer then touches the eye surface to measure the intra-ocular pressure.
These procedures are painless, the only feeling may be the machine tickling the eyelashes. Results can vary between these methods and different calibration of instruments, so it is advised to go to the same practice every time, and ask which type of equipmemt is being used, and note the results. A statement such as “Your pressures are fine” is not enough. We need actual numbers so we can compare results over time, and take dietary and other steps to halt any rising pressures before having to resort to surgical treatment.

Typical Field TestA visual field test is used to determine the field of vision. The patient sits in front of a dished screen with one eye covered, and the other eye focused on a black dot in the centre. The patient then clicks a button when a light spot is repeatedly presented in different areas of peripheral vision.The results are plotted on a graph for each eye which shows areas of lost vision such as the black areas in this plotted image of advanced glaucoma:
Typical Advanced Glaucoma Eye Plot

 

See actual improvement capable in Glaucoma patients near the bottom of this article.

Colour blindness is normally checked using the Ishihara Color Vision Test booklet, each page containing a circular pattern comprising many dots of various colors, brightness and sizes, making up a single digit number. The full test contains 38 fifferent pages, but a basic test will only involve 14 or 24 different pages. A colour-blind person will see no number, or a different number in this test. Any problems in colour blindness may indicate a health problem such as glaucoma, MS (multiple sclerosis), diabetic retinopathy, macular edema and other disorders, as well as color vision issues caused by long-term use of some prescription medications.
For colour-blind people, specially tinted glasses can improve the distinguishment and vividness of various colours as a vision aid.
The retina has cone photoreceptors, and the red and green cones are often most affected, causing “red-green colour blindness”.

Treatment

Medication helps by either reducing the production and inflow of aqueous fluid into the eye, or by increasing the outflow pathways to allow aqueous fluid to drain more effectively.
Sometimes oral medication is used, but is generally limited in effectiveness, and any improvement is lost in a short time.
Eye drops are usually the first line of treatment in newly diagnosed glaucoma.
Hint: When instilling eye drops, tilt the head backward. Use a finger placed just below the lower lid, pulling down to form a pocket. Look up and squeeze one drop into the pocket in your lower lid. Do not blink. Press on the inside corner of your closed eyes using the index finger and thumb for 2 or 3 minutes to prevent drops from draining into the throat. Wipe excess from the eye. Do not touch the tip of the bottle onto the eye or face. If hands shake, approach the eye from the side, resting the hand on the face to steady the bottle.
Commonly prescribed eye drops for glaucoma:
1. Prostaglandin analogs such as Xalatan® (latanoprost), Lumigan® (bimatoprost), Travatan Z® (Travoprost), and Zioptan™ (tafluprost) and Vyzulta™ (latanoprostene bunod) are typically used. They are used for increasing the outflow of eye fluid.
Side effects include stinging, burning, feeling as if something is in the eye, dry eyes, watering eyes, temporary unstable vision, dizziness, droopy eyelids, sunken eyes, change in the colour of the iris, eyelid, or white of the eye, vision changes, conjunctivitis (pinkeye), sensitivity to light and lengthening and curling of the eyelashes.
Often prescribed as Azarga (combination of brinzolamide and timolol) but can cause corneal erosion long-term as well as other side effects as above.

2. Beta-blockers such as Timolol (Timoptic XE, Istalol) and Betoptic S work by decreasing aqueous fluid production in the eye. Beta-blockers were once the first-line treatment of glaucoma, but just like Beta-blockers prescribed for blood pressure, have nasty side effects but are still sometimes prescribed in combination with prostaglandins.
Side effects include slowing of heart rate, heart problems, lung problems such as emphysema, diabetes, depression, stinging or discomfort of the eye, watery, dry, itchy or red eyes, blurred vision, feeling as if something is in the eye, crusting of eyelashes, headache, trouble sleeping or dizziness.

3. Alpha adrenergic agonists such as brimonidine tartrate (Alphagan®P), Iopidine®, Apraclonidine) work by decreasing production of aqueous fluid and increase drainage. Alphagan P includes a purite preservative, breaking down into natural components of tears, so may be better tolerated in those allergic to preservatives in other eye drops.
Side effects include fast or pounding heartbeats, persistent headache, eye pain, puffiness or swelling, extreme sensitivity to light, vision changes, itching, redness, burning, stinging, feeling like something is in the eye, blurred vision, redness of the eye or eyelid, nausea, upset stomach, dizziness, muscle pain, dry nose or mouth, drowsiness, insomnia or unusual or unpleasant taste in the mouth.

4. Carbonic anhydrase inhibitors (CAI’s) such as dorzolamide (Trusopt®) and brinzolamide (Azopt®) eye drops, as well as pills acetazolamide (Diamox) and methazolamide (Neptazane®). They reduce eye pressure by lowering production of aqueous fluid.
Side effects include shortness of breath, trouble breathing, unusual tiredness or weakness, blood in urine, difficult urination, depression, lower back pain, pain or burning while urinating, sudden decrease in amount of urine, bloody or black, tarry stools, clumsiness or unsteadiness, convulsions (seizures), darkening of urine, fever, hives, skin itching, skin rash, skin sores, pale stools, tinnitus (ringing or buzzing in the ears), sore throat, trembling, unusual bruising or bleeding, yellow eyes or skin.

5. Rho-Kinase (ROCK) inhibitors such as netarsudil (Rhopressa®) increase drainage of intra-ocular fluid. Originally studied for anti-erectile dysfunction, anti-hypertension, and tumor metastasis inhibition, using the same pathway as statins (with potentially similar side effects). Recently approved by the FDA as a glaucoma drug, available in USA since April 2018.
Side effects include conjunctival hyperemia, cornea verticillata and small conjunctival hemorrhages. More side effects will probably be known as it becomes more widely used.

Various combinations of all of the above are available under many different brand names. All have side effects, but there must be a balance between saving sight and dealing with sometimes serious side effects.

Various forms of laser surgery and/or surgery to create a “bleb” or artificial drainage system are used to replace the trabecular meshwork, reducing intra-ocular pressure.
Doctors say that even with surgical intervention, there is no permanent cure, and surgical procedures at best only slow down the progression of the disease.

One way to prevent or delay glaucoma is to reduce blood pressure naturally by consuming a healthy diet and reducing any extra body fat.
Low blood pressure sometimes (but not always) relates to lower intra-ocular pressure.
The same things that cause high blood pressure – trans fats (margarine, canola oil etc), sugar and high GI carbohydrates, will often also cause high eye pressure.
Do NOT be taken in by statin drugs – designed to lower cholesterol. Cholesterol is NOT the evil it is made out to be, in fact we would die without it. Treating 100 people with statins may prevent one heart attack in one person. Changing to a healthy diet will prevent almost all of the 100 from heart attacks.

Glaucoma NO list

Bad fats
1. Margarine – do not be fooled by unscrupulous advertising from margarine manufacturers who claim that margarine reduces cholesterol. Maybe it does, but cholesterol is not our enemy, only OXIDISED Very Low LDL is bad, and that is the dangerous ingredient in margarine. Alternative: Coconut oil, butter from grass-fed cows, cold olive oil.
2. Canola oil – heat processed in the manufacture oxidises this fat. Cooking with canola oil oxidises the fat even more. NEVER use canola oil for anything.
Alternative: Coconut oil.
3. Sunflower Oil. Flaxseed oil is a much healthier alternative.
4. Hydrogenated oils of any kind. Common in many low-fat baked goods and other processed foods.

Bad drugs
1. Paracetamol, panadol, acetaminophen, tylenol – different names for the same drug marketed as “safe and effective” but it destroys L-Glutathione, the body’s own master antioxidant. Alternatives for pain:
(a) MSM – primarily for joint pain but helps reduce the sensation of any pain.
(b) Bacopa – primarily for slight blood thinning and higher brain function, but also helps with pain.

2. Statins – cholesterol lowering drugs that increase risk of diabetes, clobber our Vitamin D, cause muscle pain and kidney disease, and on average will slightly reduce risk of a heart attack but increase death risk from all other causes, so most people taking statins will not live one day longer, and have a poor quality of life.

Glaucoma Diet

Diet will not cure Glaucoma, but will reduce risk, slow degradation and delay surgery.
Natural methods aim to reduce IOP, increase blood flow to the eye, and lower oxidative stress, just like traditional drug methods.
We can lower glaucoma risk by eating more fresh vegetables and fruits containing Vitamin A, Vitamin C and Lutein with Zeaxanthin, foods high in carotenoid antioxidants such as green leafy vegetables and other green or yellow vegetables. Cooked kale and cooked spinach are best, also egg yolks.
A study showed that women who ate 3 or more daily servings of fruits and fruit juices reduced glaucoma risk by 79% compared to those who consumed less than 1 serving per day.
Those people with high intake of vitamin C levels reduced risk by 70%, while high vitamin A reduced risk by 63%, and alpha-carotene by 54%.
However, not every vegetable or fruit works as well. These foods are proven to cut glaucoma risk:

  • Kale, Cabbage, Broccoli, Collard Greens
    The NIH study showed that 3 or more daily servings of general vegetables had little effect on glaucoma risk, but one serving of kale or collard greens per week reduced glaucoma risk by 57%, and a Harvard study suggested that the benefit is in the high nitrate levels, a precursor for nitric oxide which promotes health of blood vessels. This study (Nurses’ Health Study of 63,893 women, 1984-2012 and Health Professionals Follow-up Study 41,094 men, 1986-2012) found that high dietary leafy greens (= more nitrates) meant 20% to 30% reduction of glaucoma risk. For glaucoma linked to poor blood flow, nitrates reduced risk by 40% to 50%
  • Oranges and Peaches
    The NIH study found that women who consumed more than two servings per week of fresh oranges reduced their risk by 82% while peaches cut their risk by 70%. Whole fresh fruit was best. Juice only gave less benefit, even if they drank it every day. LeanMachine concludes this is due to heat and sugar processing of juice. Fresh peaches were protective, while canned peaches were not. LeanMachine concludes this is due to sugary syrups and heated processing for canned fruit
  • Wild-Caught Salmon
    A British study of glaucoma patients and their healthy siblings, glaucoma patients had lower levels of EPA (eicosapentaenoic) and DHA (docosahexaenoic) fatty acids and total omega-3 long-chain polyunsaturated fatty acids, suggesting that EPA and DHA could improve microcirculation, ocular blood flow and optic neuropathy, which are all associated with glaucoma. Other good sources of EPA and DHA include fatty cold-water fish, e.g. sardines, mackerel, herring and tuna
  • Healthy Fats
    Healthy fats are essential to change the body’s carbohydrate-fueled system into a fat-fueled system where ketones are the primary fuel.
    Best fats are coconut oil, avocados, walnuts, fish oil, krill oil, macadamia oil, butter. Cold-pressed virgin olive oil is healthy when cold (i.e. on a salad) but oxidises when heated
  • Green Tea, Cocoa, Red Wine
    Another study found that flavonoids improved vision and slowed progression of visual field loss in patients with glaucoma and high eye pressure. Read more about flavonoids in my Flavonoids article. Flavonoids are neuroprotective and antioxidant polyphenol compounds found in plants, highest in green tea, red wine and cocoa. LeanMachine says that Cocao (less processing) should be more beneficial than Cocoa
  • Black Currants
    A 24-month trial showed that black currant anthocyanins slowed the visual field deterioration, probably because the black currants improve blood flow in the eye
  • Goji Berries
    An animal study of the goji plant Lycium barbarum L. found it prevented the loss of retinal ganglion cells and neurodegeneration. Benefits found were independent of eye pressure. Animals fed a goji extract nearly totally escaped from pressure-induced loss of retinal ganglion cells. LeanMachine suggests that other high antioxidant foods such as blueberries may also have beneficial effects
  • Eggplant
    In a study of male volunteers, they ate 10 grams of eggplant (Solanum melongena L.) and showed a 25% reduction of intra-ocular pressure, suggesting that eggplant would be beneficial to glaucoma patients

Cooking Methods

Heating food over around 50 degrees Celcius (about the temperature of hot water at the kitchen sink) destroys most of the beneficial enzymes, so salads, fruit or other cold foods should be consumed at at least one meal every day. An organic apple a day definitely keeps the eye doctor away…
When cooking, the safest way is steaming (100 degrees Centigrade). Other cooking methods heat food well over the safety limit of 120 degrees Centigrade. Over 120 degrees, AGEs form (Advanced Glycation End-products) which damage the mitochondria and many other body systems.

Supplements for Glaucoma

While healthy foods will help delay glaucoma, as well as reducing risk of diabetes, cardiovascular disease, Alzheimers, obesity and more, there is often not enough healthy content available due to intensive farming practices, combined with chemical additives in the soil, to give the glaucoma patient enough of the correct nutrition.
Lean Machine recommends a combination of a healthy diet, supplements and sun exposure for optimum nutrition.
Oxidative stress is a major factor in progression of glaucoma, so antioxidants are important.
Various vitamins and minerals have been proven to reduce glaucoma symptoms, but eye doctors seldom pass on this information.
Supplements do not make up for a bad diet. Supplements often only supply a single important extract, but whole, natural foods contain fibre, enzymes and many other important compounds, so LeanMachine recommends a combination of both.
The following are the main supplements LeanMachine recommends for glaucoma patients:

In addition, foods improving mitochondria are:
1. Proteins such as fish, nuts, seeds, beans, lentils, eggs that support glutathione and other amino acids which protect the mitochondria.
2. Antioxidants – colourful vegetables, fresh fruit, herbs, spices. Best spices are cloves and turmeric.

Supplements for Glutathione include:

Glaucoma can get better

Mrs LeanMachine was diagnosed with an aggressive form of Glaucoma at age 48, which is much younger than most, and blindness often follows in 5 to 10 years. However, due to a reasonably healthy lifestyle, degradation was slow, but consistent.
Right Eye scan. Black areas represent loss of vision, grey represent partial loss.

Right eye scan, January 2014
Right Scan January 2014, age 68 Right Scan January 2020, age 74

Her Opthalmologist has never seen improvement, especially this much improvement in any Glaucoma patient.
The main change in the last few years has been an array of Vitamins, Minerals and Nutrients, and a healthy diet, free from all hydrogenated oils and bad fats (e.g. Margarine, Canola Oil).
Another victory for LeanMachine! In addition, Mrs LeanMachine is now free from diabetes, blood pressure, never gets a cold or flu, has no prescription medication, no eye drops, no vaccinations. In fact, the biggest improvement was seen since she stopped taking the prescribed eye drops (because of side effects).

NADH Studies
Declining NAD+ Induces a Pseudohypoxic State Disrupting Nuclear-Mitochondrial Communication during Aging (2013) – http://jmp.sh/s1CKUez – this article (more technical/scientific) was the catalyst for the NAD+ research momentum which presently exists

NAD – Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in Mice (2016) http://jmp.sh/6GZMwPq – the infographic on the cover page pretty much sums up the effects in humans too

NAD – Short-term administration of Nicotinamide Mononucleotide preserves cardiac mitochondrial homeostasis and prevents heart failure (2017) http://jmp.sh/yHKH355

NAD – Nicotinamide mononucleotide supplementation reverses vascular dysfunction and oxidative stress with aging in mice (2016) http://jmp.sh/B4OET23

NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice (2016) http://jmp.sh/IlxzSUx

NAD – Loss of NAD Homeostasis Leads to Progressive and Reversible Degeneration of Skeletal Muscle (2016) http://jmp.sh/XjlgLOV

NAD – Nicotinamide mononucleotide improves energy activity and survival rate in an in vitro model of Parkinson’s disease (2014) http://jmp.sh/gnAHrz3

NAD – Nicotinamide Mononucleotide, a Key NAD+ Intermediate, Treats the Pathophysiology of Diet- and Age-Induced Diabetes in Mice (2011) http://jmp.sh/UlRkYGD

NAD+ in aging, metabolism, and neurodegeneration (2015) http://jmp.sh/pkSKzz3

NAD – Exogenous NAD+ administration significantly protects against myocardial ischemia-reperfusion injury in rat model (2016) http://jmp.sh/ufBDDWA

NAD – Prevention of Traumatic Brain Injury-Induced Neuron Death by Intranasal Delivery of Nicotinamide Adenine Dinucleotide (2012) http://jmp.sh/iGqzbgo

NAD+ controls neural stem cell fate in the aging brain (2014) http://jmp.sh/tlIvnhg

NAD+ Deficiency in Age-Related Mitochondrial Dysfunction (2014) http://jmp.sh/DGwKD45

NAD – The NAD+ Precursor Nicotinamide Riboside Enhances Oxidative Metabolism and Protects against High-Fat Diet-Induced Obesity (2012) http://jmp.sh/vTHsM1r

NAD – Nicotinamide mononucleotide inhibits post-ischemic NAD+ degradation and dramatically ameliorates brain damage following global cerebral ischemia (2016) http://jmp.sh/iqJczKC

NAD – Effect of nicotinamide mononucleotide on brain mitochondrial respiratory deficits in an Alzheimer’s disease-relevant murine model (2015) http://jmp.sh/8oIdCfo

NAD – Nicotinamide Mononucleotide, an Intermediate of NAD+ Synthesis, Protects the Heart from Ischemia and Reperfusion (2014) http://jmp.sh/WwBFWdR

NAD – Restoration of Mitochondrial NAD+ Levels Delays Stem Cell Senescence and Facilitates Reprogramming of Aged Somatic Cells (2016) http://jmp.sh/L3dXEm1

NAD – Nicotinamide Mononucleotide, an NAD+ Precursor, Rescues Age-Associated Susceptibility to Acute Kidney Injury [was ‘AKI’] in a Sirtuin 1–Dependent Manner (2017) http://jmp.sh/cWda60C

NAD – NAD replenishment with nicotinamide mononucleotide protects blood–brain barrier integrity and attenuates delayed tissue plasminogen activator-induced haemorrhagic transformation after cerebral ischaemia (2017) http://jmp.sh/mkmiXxP

NAD – Nicotinamide mononucleotide inhibits JNK activation to reverse Alzheimer disease [2017] http://jmp.sh/GhDCkte

Disclaimer

LeanMachine is not a doctor, and everyone should consult with their own health professional before taking any product to ensure there is no conflict with existing prescription medication.
LeanMachine has been researching nutrition and health since 2010 and has completed many relevant studies.

Copyright © 1999-2020 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285